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7/31/2019 Med Lab Revision
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Medical Laboratory Sciences
II
2 hour Examination
Section A Short question answers
Section B 1 hour essay question
Choice of 1 out of 3
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What Have we Learnt?
BloodGrouping
Haemolyticdisease ofthe newborn
Bloodproducts
Bloodconservation
Introduction
LiverFunction
Kidney, Heart& Thyroidfunction
PaediatricBiochemistry
Genetics
Urinary TractInfection
SexuallyTransmittedDisease
Enterics
GeneralBacteriology
Virology
Blood Bank Biochemistry Microbiology
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Blood Bank Blood Grouping
ABO System What is it?
Why is it particularly important?
Typing Forward and reverse groupings
RhD
Cross matching
Coombs test
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Blood Bank HDN
Clinical scenario
Routine serology
Screening/Prophylaxis Maternal/paternal/foetal
Significant alloantibodies
Management of HDN Prophylaxis RAADP
Liley chart
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Blood Bank Blood Products
Whole Blood
Fresh Frozen Plasma (FFP) Indications for use Preparation
Red Cells in SAGM Indications for use What is it?
Platelets Indications for use Preparation and administration
Cyroprecipitate, Serum immunoglobulins,Albumin
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Blood Bank Conservation
SHOT
Shortages
Short term, acute, long term
NBS Plan for Management Green, Amber, Red phase
Autologous transfusion PAD, ANH, CellSalvage
Management of Hb levels
Emergency blood management group
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Example Questions:
1. Haemolytic disease of the newborn (HDN) is caused bytransplacental passage of maternal alloantibodies directedagainst foetal red cell antigens.
a) What is meant by the term alloantibody?
An antibody produced by one individual that reacts with allontigens
of another individual of the same species.(1 mark)
b) Which class of antibody usually facilitate HDN reactions due totheir ability to cross the placenta: IgG, IgA or IgM?
IgG(1 mark)
c) Why is it particularly important to identify Rhesus D (RhD)negative, pregnant women prior to their giving birth?
(5 marks)
d) Other than anti-RhD, name 3 other significant alloantibodiesassociated with HDN
(3 marks)
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Example Questions:
2. Conservation of blood donated through theBritish Blood Transfusion Service is ofincreasing importance. Briefly outline someof the possible scenarios that may contributeto short term shortages, acute shortages and
prolonged shortages.
In July 2004, the Department of Health issueda plan for the management of bloodshortages in the UK, integrated using a trafficlight system. Outline what is meant by thetraffic light system and provide a criticalanalysis of some of the new measuresintroduced to help conserve blood usage.
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Example Questions:
2. Conservation of blood donated through theBritish Blood Transfusion Service is ofincreasing importance. Briefly outline someof the possible scenarios that may contributeto short term shortages, acute shortages and
prolonged shortages.
In July 2004, the Department of Health issueda plan for the management of bloodshortages in the UK, integrated using a trafficlight system. Outline what is meant by thetraffic light system and provide a criticalanalysis of some of the new measuresintroduced to help conserve blood usage.
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Biochemistry Introduction
Specimen collection Different preservatives
Sample integrity Haemolysed, icteric, lipaemic
Transport conditions
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Biochemistry Liver Function
Normal functions of the liver Normal structure of the liver
LFT Bilirubin, Albumin, ALP, ALT, AST, GGT, LDH
Clinical interpretation
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BiochemistryKidney, Heart &Thyroid Renal Function
Normal function renal function eGFR, CCT, Urea, Creatinine, Sodium, Potasium,
Proteinuria, Microalbumin urine test, Urine osmolarity,Transferrin saturation, Stone screen
Cardiac Function Myoglobin, LDH, AST, CK (-MM, -MB, -MM), Troponin (-
T, -I), hsCRP, NT-proBNP
Thyroid Function Normal thyroid function Hyperthyroid vs hypothyroid FT3, FT4, TSH, anti-TPO, anti-TSH Receptor
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Biochemistry Paediatrics
Terms Neonate, Preterm, Term, Extreme preterm
Why are paediatric cases different Specimen collection
Specimen analysis
Data interpretation
Inherited conditions Phenylketonuria, Niemann-Pick (C & D), Congenital
hypothyroid, Sickle cell, MCADD, Cystic fibrosis
Screening Wilson & Jungner
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Biochemistry Genetics
What is it, Why do it, How do we do it Screening, Counselling, Extraction, PCR, Southern
blotting, Cytogenetics, Genotyping
Inheritance Autosomal dominance, recessive, Penetrance,
Variability
Clinical examples Huntington, Cystic fibrosis, Mitochondrial disorders,
X-linked disorders, Downs, Fragile X,Haemochromatosis. AAT
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Example Questions:
3. Clinical Biochemistry routinely assesses organ function.
a) State 4 tests used to assess renal function(2 marks)
b) Provide a clinical interpretation of an abnormal result foreach of the 4 tests you have named above.(4 marks)
c) State the full name of each of the following analytes used toassess liver function:
(3 marks)
AST, ALT, LDH
d) Free thyroxine is measured as part of the assessment ofwhich organ?
(1 mark)
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Example Questions:
4. A 40 year old male presents to his GP withpalpitations, shaking, lethargy and weight loss.Upon further examination the GP sees signs oftachycardia, moist skin and exophthalmos.Graves disease is suspected and a blood sample
sent to the Pathology department.
Describe the thyroid hypothalamus-pituitary axis,detailing how this is disrupted in the onset ofGraves disease. What tests would be requested
and how would a Biomedical Scientist interpretthese results to differentially diagnose Graves?Briefly outline a possible treatment strategyconsidering long and short term aims for thismans condition?
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Example Questions:
4. A 40 year old male presents to his GP withpalpitations, shaking, lethargy and weight loss.Upon further examination the GP sees signs oftachycardia, moist skin and exophthalmos.Graves disease is suspected and a blood sample
sent to the Pathology department.
Describe the thyroid hypothalamus-pituitary axis,detailing how this is disrupted in the onset ofGraves disease. What tests would be requested
and how would a Biomedical Scientist interpretthese results to differentially diagnose Graves?Briefly outline a possible treatment strategyconsidering long and short term aims for thismans condition?
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Microbiology - STIs
Basic anatomy, male and female
Gonorrhoea, Syphillis, Chlamidia Transmission
Clinical features Pathogenesis
Lab diagnosis: Specimen collection, Culture,Microscopy (light, dark, morphology), Gram stain,Oxidase test, Biomerieux, ELISA, PCR, Sensitivity
testing Treatment/prevention
General basic knowledge Genital herpes, Genital warts, Pubic lice,
Trichomoniasis, Vaginal candidosis
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Microbiology - UTIs
Basic anatomy, male and female Host defence
Symptoms Terminology
Causative organisms Inpatients/outpatients
Specimen collection Critical analysis
Laboratory investigation Microscopy, casts, Flow cytometry, Culture, Chromogenic media.
Kass criteria
Treatment/prevention
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Microbiology and Virolgoy
Apologies, I did not receive thefollowing talks in time to put thispresentation together before going on
leave. You will have to review andsummarise these two lectures foryourselves.
Medical Microbiology: Respiratory &Gastro Infection
Medical Virology
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Example Questions:
5a) Give two reasons why UTIs are more common in femalesthan males.(2 marks)
b) What is the most common cause of UTIs in the public?(1 mark)
c) Discuss how the causative agents of UTIs found in hospitalinpatients are likely to differ from those found in the generalpublic.
(3 marks)
d) Critically analyse the different types of specimen andspecimen collection methods used to investigate suspectedUTI.
(4 marks)
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Example Questions:
6. Discuss the aetiology and clinicalsymptoms of Mycobacterium tuberculosis(TB) infection. Critically discuss thelaboratory investigations that may beconducted by a Biomedical Scientistinvestigating a possible case of TB,including the advantages and
disadvantages of the different tests thatcould be requested. Briefly outlinepossible treatment and preventionstrategies.
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Example Questions:
6. Discuss the aetiology and clinicalsymptoms of Mycobacterium tuberculosis(TB) infection. Critically discuss thelaboratory investigations that may beconducted by a Biomedical Scientistinvestigating a possible case of TB,including the advantages and
disadvantages of the different tests thatcould be requested. Briefly outlinepossible treatment and preventionstrategies.
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